Study objectives: Nasal continuous positive airway
pressure (nCPAP) is the most common treatment for obstructive
sleep apnea (OSA) in adults, and it has been effective in the treatment
of OSA in children. We wanted to determine the effectiveness of
long-term nCPAP therapy for OSA in infants.
Twenty-four infants who had OSA were treated with nCPAP via nose mask.
These infants had clinical histories that included a family history of
sudden infant death syndrome, an apparent life-threatening event, or
facial and upper airway anatomic abnormalities.
Interventions: Overnight polysomnographic studies were
performed to assess the severity of OSA in each infant and to determine
the appropriate level of continuous positive airway pressure
(CPAP). Studies were repeated to determine the progress of OSA
and the continuing need for CPAP in each infant.
Results: nCPAP pressures between 4 and 6 cm H2O
prevented obstruction and reversed sleep disturbances that were
associated with OSA. Eighteen of the infants continued treatment at
home from 1 month to > 4 years. CPAP therapy was discontinued in 13
infants after their OSA resolved. Five infants who have upper airway
anatomic abnormalities remain on CPAP, and the pressure level required
to prevent obstructive events during sleep has needed to be increased
to as high as 10 cm H2O.
nCPAP is an effective therapy for the management of OSA in infants, and
it can be used effectively in the home environment. Regular follow-up
is necessary, because the requirements for CPAP and pressure levels
change with the infant’s growth and